Multidisciplinary approach in the pelvic relapse of a previously irradiated cervical tumor
Daniel Vázquez-Vicente 1 , Teresa Castellanos 2 , Alvaro Cabello 3 , Enrique Chacon 2 , Jose Angel Minguez 2 , Luis Chiva 2
This educational video shows a step by step approach for anterior infra levator exenteration with colpectomy along with intraoperative radiation for recurrent/persistent cervical cancer in a patient with one kidney. The patient underwent urinary diversion and neovaginal reconstruction.
A 31-year-old woman with a past medical history of systemic lupus erythematosus and congenital absence of the left kidney was diagnosed with a 4 cm IIA squamous cervical carcinoma in the context of immunosuppressive therapy. Beyond the proximal vaginal involvement, the workup failed to show any extracervical disease.
Standard concomitant chemoradiotherapy resulted in a questionable partial response. Four months after chemoradiation, pelvic magnetic resonance imaging showed a 4.5 cm persistent cervical mass along with mild right hydronephrosis and vaginal involvement. Positron emission tomography-computed tomography (PET-CT) confirmed the metabolic activity of the cervical tumor without demonstrating distant metastases.